OP0202-PARE NRAS New2RA RIGHT START SERVICE FOR PEOPLE RECENTLY DIAGNOSED WITH RA
Authors: A. Bosworth, C. Jacklin
Journal: Annals of the Rheumatic Diseases (2022)

Background The National Rheumatoid Arthritis Society (NRAS) follows best practice, evidence-based standards in all we do. Huge strides have been made in the diagnosis and treatment of Rheumatoid Arthritis (RA), but impact on quality of life can be significant and for many, RA remains hard to come to terms with. Anxiety and depression are frequent co-morbidities seen in RA, and this can impede people’s ability to acquire knowledge of their disease together with supported self-management skills and coping strategies. Objectives The aim of Right Start (RS) is to improve outcomes of the recently diagnosed with RA through a framework of emotional, educational and peer support, and access to high quality supported self-management resources tailored to individual need. RS also enables us to dispel myths and unhelpful health beliefs so that people get the ‘right start’ on their journey with RA to maximise health outcomes. A diagnosis of an incurable disease treated with life-long strong drugs is a life-changing event and without the right support it can be an isolating and emotionally very challenging experience for both the individual and their close family. We also wanted to give an understanding of the key role that supported self-management can play in improving quality of life, giving people back some control over their symptoms. Our goal was also to create a quick and easy way for HCPs to refer their patients to Right Start in a consented and GDPR compliant way. Methods HCPs are able to refer their patients via the ‘Refer a patient’ button on our website which takes them to a simple form which is filled in and submitted to NRAS with the patient’s consent. NRAS receive the referral and the form is integrated with our Salesforce database, and we contact the patient. RS involves a simple, 4-step process and the individual receives: A call (up to 1 hr) with a member of our helpline; 1:1 peer support (phone/Teams/Zoom) from trained volunteers with RA and access to 24/7 online community support; a tailored package of hard copy information with e-links/video/webinars of interest sent by post; further follow up available from helpline and individual peer support. RS enables health professionals to meet their responsibilities against NICE Quality Standard 33, Statement 3, (patient education and access to self-management resources) on which they are audited through National Early Inflammatory Arthritis Audit (NEIAA). RS is included in the NICE shared learning database of best practice examples. RS also supports the EULAR Recommendations for implementation of self-management strategies in inflammatory arthritis. Results Since launch at BSR 2019, over 90 UK rheumatology units have referred over 435 patients to this service. Approx. 1/3 rd cannot be contacted and after 3 attempts a letter and newly diagnosed pack are sent, inviting contact at future date. Anecdotally people are highly satisfied with this service and a number of units are referring multiple patients where the service is embedded in the patient pathway. To gather empirical data on the impact of the service NRAS has partnered with Manchester University to undertake an Enhanced Right Start pilot in 5 UK rheumatology units involving the use of validated patient reported outcome and experience measures from users recruited, and quantitative/qualitative data from health professionals. The pilot is due to commence recruitment in early Feb, 2022. Meantime, referrals to the standard service continue to grow. Conclusion Workforce shortages in all posts within the multi-disciplinary team), 2 years of pandemic resulting in HCPs under immense pressure and time poor with a large backlog of patients has meant it’s extremely difficult for HCPs to meet Quality Standards and goals of audit. Feedback informs that HCPs find Right Start a beneficial service to refer their patients to and people with RA have found it more than helpful. We anticipate that the results of the Enhanced Right Start Service Pilot (see Results) will provide additional evidence to support HCP patient-referral to this service. Acknowledgements I would like to acknowledge the support of a number of UK consultant rheumatologists in the early stages of the development of this service, in particular Dr. James Galloway. Disclosure of Interests Ailsa Bosworth Speakers bureau: Where I have in the past the honorarium has been paid to NRAS not to me personally, Grant/research support from: Unrestricted educational grants have been paid to NRAS by a number of pharmaceutical companies in last year, Clare Jacklin Speakers bureau: Where I have in the past the honorarium has been paid to NRAS not to me personally, Grant/research support from: Unrestricted educational grants have been paid to NRAS by a number of pharmaceutical companies in the last year.